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Therapy: Understanding Life with Autism

BY CAROLINE KORNEGAY: STAFF WRITER
July 3, 2006

Maryann Sarno knows all about temper tantrums.

More infor

Delaney, Sarno's granddaughter, has pitched a temper tantrum or two for the record books.

What is upsetting her is sometimes a mystery to Sarno. Delaney Sarno is autistic, making it harder for her to communicate.

Sarno has heard the tsk-tsking of parents and grandparents around her who think she has a bratty, uncontrollable child.

Autism is a brain disorder that affects social and personal behavior.

"A lot of times, lights and noise and confusion of big crowds like here or in Wal-Mart, it's the fluorescent lights, is really what it is," she says. "When the kids are having what we call meltdowns, they just look like they are misbehaving, (and) they are misbehaving as far as (action goes) but they really cannot help it."

Delaney's frustration and confusion can bubble over in public settings.

The disorder has many different subgroups and has a spectrum of symptoms, it is referred to as Autism Spectrum Disorder.

In North Carolina, between 25,000 and 30,000 individuals have been diagnosed with the condition, according to the TEACCH Web site provided by the University of North Carolina at Chapel Hill.

Research from the Centers for Disease Control suggests as many as 1 in 166 people in America fall somewhere on the ASD spectrum.

"It can be a challenge," her mother, Kristen Sarno, says. "Autistic children really need a routine and a structured schedule. Laney is pretty good if we have a change in structure, she can pretty much flow with it, but there are some times that she can't handle it, especially if we go to a store, and it gets to be overwhelming or too much.

"She's an awesome kid. Unbelievable."

To help her keep a routine, Delaney Sarno is in Donna Hennings' class for children with special needs at Southern Pines Primary.

Hennings works with 5- to 8-year-olds in the class at Southern Pines Primary, one of the first schools in the county and region to have a program designed specifically for the needs of autistic students.

Teachers use a strict and closely followed behavior program that teaches the students like Delaney how to get through a typical day.

Hennings has worked with autistic children in Moore County Schools since the late 1970s.

When she started teaching, she had five children from three counties, she says. Today she has 11 children just from the Southern Pines area.

Her students usually don't communicate very much, and have a very hard time understanding what other people are saying to them, Hennings said.

Children with autism are usually more sensitive to sights and sounds, and can react strongly to something as simple as a handshake, or in Delaney's case, fluorescent bulbs.

The students in the class vary along the autism spectrum.

Each student has an individual routine for the day and each has his or her own schedule and small, laminated pictures in a row that help to identify the activities they need to do at given times.

The laminated picture cards are specifically tailored to the needs of the individual child.

Students have their own personalities, their own likes and dislikes, and Hennings tries to modify books and activities to her students' abilities.

"Each one is really like a little puzzle," Hennings says.

Many people with ASD have a difficult time following one action with another.

Putting a sock on the left foot doesn't mean that a sock will go on the right foot.

In Hennings' class a picture of a blue toothbrush tells a child that his next activity is to brush his teeth.

"You need to think about what you do because they don't know what to do," Hennings says.

Impulse control is a big part of what she tries to help her children develop, Hennings says.

"It takes a lot of patience," Hennings says.

Autistic children do not understand what is dangerous, or repetitious, so they can get stuck on one activity and will do the same thing for hours on end, forgetting what they started doing in the first place.

Visual clues like the cards, repetition, and organization all help the students get through the day.

Even if the students can't speak, organizational charts help them with activities and coping behaviors written out for the teachers if they get upset.

"What we do to accommodate that is we use a lot of pictures," Hennings says.

Hennings makes a large majority of the materials in the room herself.

"There aren't a lot of materials for kids with autism," she says.

Ritualized behavior are common indications that a child is autistic.

Some scientists say some classic autistic behaviors such as rocking or flapping of hands are ways to calm themselves, or make themselves aware of where they are in relation to other objects or people.

Specific causes of autism are unknown, and it tends to be a very misunderstood disorder.

"Someone likened it to being in a foreign country, knowing the language, but then being bombarded by sensory (stimuli), like noise. (Also) the person speaking too fast," Maryann Sarno says. "One of the things that we noticed early on was she removed herself. I really noticed that especially when there are a lot of other things going on."

Almost all people on the ASD spectrum have at least some level of difficulty in communicating.

Language skills are late to develop, if they develop at all, depending on how severely the disorder affects the brain.

"Having a conversation is really difficult for Delaney," Kristen Sarno says.

Finding the correct words isn't easy, she says.

"She will sometimes get words mixed up, pronouns especially," says Maryann Sarno. "She is very intelligent and I think that a lot of these children are misdiagnosed or misunderstood because they can't verbalize what's going on. They can't really tell you what they know."

As Hennings and the Sarnos well know, a change in routine can be traumatic.

"Trying to incorporate changes is a very slow, methodical process," Hennings says.

She takes her students on field trips into the community to help them adjust to their surroundings and make things more familiar.

"They still have to learn to live in society and that's one of the things that they do in school. You have to teach them things that we just learn automatically," Maryann Sarno says.

Students also attend a water therapy class on Friday mornings at the FirstHealth Center for Health and Fitness in Southern Pines.

The outing in the pool is one more way to build necessary skills.

The water is soothing for the children, but it also helps reinforce the everyday activities of dressing and undressing, showering, and following the leader.

Martha Miller leads the class, and she's used to working with children who are afraid of the water.

"That has been such a great experience," Hennings says of the water therapy.

Students and teachers alike call her "Miss Martha."

"And one of the things about the water therapy is that it puts them on much more equal ground with other children," says Maryann Sarno. "They really need a lot of physical therapy. They need to do very physical things, and I don't see a lot of that in the schools.

Kristen Sarno, works with Delaney to try and reinforce what she has learned in class.

"I do try and change it up, I know she needs it (behavior modification) for her behavior, but I also don't want her to get 'stuck.' I'm trying to mainstream her at this point; I want her to be able to interact with other kids."

Even though Delaney would most likely need a personal aide, like many of the children in her class, she would do well, her mother thinks.

"She can survive in a classroom," says Kristen Sarno.

There has been a sharp increase in the past two decades in the number of cases of autism, Hennings says. The need has grown but the public is largely unaware, she adds.

What most people don't realize is there are fabulously talented citizens with ASD living and working in their communities.

"It takes a person who can focus so totally (on that subject)," Hennings says. Some breakthroughs in marketing, math, science and art have been made by people with ASD.

Temple Grandin, a woman with autism, revolutionized the humane slaughter of cattle for the beef industry. People with autism can devote copious amounts of their time to singularly focus on a subject, or an aspect of a problem until they find a solution, or have worked through it.

Best known in the movie "Rain Man," autism shapes the world of not only the person with the disorder, but also the family.

Mary Anne Sarno and Christine Garton are two family members who have formed Parents of Amazing Children, a support group of The Family Support Network of the Sandhills . PAC can be reached at 692-6123 (ext. 15).

Christine Garton's son Scott just turned six last month, and he becomes very upset if his mother shows up unexpectedly at Hennings' class.

What most parents don't understand are the challenges they will face with an autistic child, and most parents don't know how lucky they are, Hennings says.

Sarno, Garton, and others are trying to raise awareness of the disease to make life a little easier for their families and for their children.

The group is a way they can lobby together for the things that are necessary for their children.

"We all want services and we want the best for our children," Garton says. "Everything has to be catered to these children."

The group meets the last Monday night of every month at Our Saviour Lutheran Church, in Southern Pines.

The women have a speaker and hold open meetings, and are trying to educate everyone they can, particularly those most involved with the children, such as teachers and doctors.

Doctors aren't always educated about the disease, and can misdiagnose autism, she says.

Delaney Sarno was originally diagnosed as developmentally delayed with Attention Deficit Hyperactivity Disorder, her mother says.

The earlier the diagnosis is made, the earlier the family can begin to cope with the child's behavior and special needs.

Maryann Sarno wishes there were a little more tolerance and understanding.

"Delaney has to learn to conform to the general public," she says. "I'm hoping that the schools and that the administration and the public in general start to understand about these children and be more tolerant in general. They have so much to offer and such an interesting way of looking at things."

Caroline Kornegay can be reached at 693-2484 or by e-mail at ckornegay@thepilot.com.

 

 

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